ARSENIC IN DRINKING WATER AND URINE AND ITS RELATIONSHIP WITH MALIGNANT TUMORS OF URINARY TRACT IN OSIJEK-BARANJA COUNTY, CROATIA.

Increased values of arsenic in potable water in eastern Croatia has been a matter of scientific interest for the past two decades due to numerous health effects, including carcinogenic ones. This study investigated whether prolonged exposure to increased arsenic from water could be detectable through increased arsenic in urine, and whether it influenced the incidence of kidney and bladder cancer in Osijek-Baranja County. Inductively coupled plasma mass spectrometry (ICP-MS) was used for analysis of water samples from available water sources (wells, aqueducts). In addition, examinees from Osijek, Nasice, Vladislavci, Cepin and Dalj gave their urine samples for analysis. Data on cancer incidence were obtained from the Institute for Public Health Registry and cumulative incidence of kidney and bladder cancer was calculated for the period between January 1, 2000 and December 31, 2018. Elevated arsenic concentration in drinking water was recorded in Vladislavci, Cepin and Osijek area with values above the allowed maximum according to the EU standards (10 µg L-1) and as a result, arsenic levels in urine of the inhabitants were also elevated. Cumulative incidence for bladder cancer showed correlation between increased arsenic in water and urine in the areas affected by increased arsenic in water. Epidemiologic data suggest a conclusion that elevated arsenic could be considered at least as a cofounding factor for urinary tract cancer.

Determinations of uranium concentrations in soil, water, vegetables and biological samples from inhabitants of war affected areas in eastern Croatia (ICP-MS method).

The occurrence of elevated uranium levels in post-war areas raise concerns among populations, especially in areas affected by heavy bombardment and potential use of depleted uranium weapons. The aim of this study was to assess public exposure to the uranium Water, soil, vegetables, urine, serum and hair samples were collected for the first time in eastern Croatia and analysed using an inductively coupled plasma mass spectrometry (ICP-MS) method, in order to try to explain the possible origins of uranium in the population and environment. Urine, serum and hair samples were collected from 389 inhabitants. A large variation of uranium concentrations in urine, serum and hair samples was found in this study. The majority of urine, serum and hair samples from our study had uranium concentrations below the reference literature values. A higher uranium concentration in the hair of 4% of inhabitants, mostly from rural areas, could not be explained at this stage of research. A further, extended epidemiological study should be made of uranium in the region.

[Excessive daytime sleepiness--as possible suicidal equivalent in people with depressive disorder]. / Prekomjerna dnevna pospanost kao moguci suicidalni ekvivalent u osobe oboljele od depresivnog poremecaja.

This paper presents the case of a patient suffering from atypical depression, with excessive daytime sleepiness, which was a suicidal equivalent. Patients who suffer from depression and sleep disorders can have an increased risk of suicidality, and to them should pay increased attention. Field of suicide as a means of resolving conflicts and unconscious mental escape from the reality of the obstacles, including sleep and daytime sleepiness, which may represent a form of "temporary suicide". The authors recommend that hypersomnia, daytime sleepiness in depressed patients and other sleep disorders should be treated as a potential risk factor for suicidal behavior.

[The influence of "hygienic minimum" course on quality of catering establishments]. / Utjecaj tecaja "higijenskog minimuma" na kvalitetu ugostiteljskih objekata.

The aim of this article was to define the quality of catering establishments in Virovitica Podravina county before and after the course of "hygienic minimum". Research was realized through interview and assessment of microbiological swabs of the same catering establishments before and after the course of "hygienic minimum". All procedures were performed according to Regulations on standard specification in microbiological cleanness and methods of its determining. Twenty-five catering establishments from a group of restaurants and bars were analyzed. In all of them we found improvement in the most of examined parameters. So, implementation of the course through the existing program has proven to be justified.

The effect of pest control on the incidence of trichinosis in Virovitica-Podravina County, Croatia.

The aim of the study was to assess the role of pest control as a preventive measure in the control of trichinosis. The investigation was designed as a retrospective cohort study in the Virovitica-Podravina County. The incidence of trichinosis was determined according to the presence or absence of exposure to protective pest control measures. Differences in the rate of trichinosis infection were determined by calculating relative risk (RR), i.e., the ratio of absolute risk in the two groups. In this epidemiological study, data collected in the County area regularly covered by pest control (exposure area) were compared with other areas not covered by regular pest control measures (non-exposure area). The study included 132 subjects living in the County and locally infected with trichinosis. Patient data were obtained from their medical history, epidemiological survey and epidemiological questionnaire on the source (autochthony) of the disease. The study also included 133,028 domestic pigs, 875 wild animals (mostly wild boar) and 111 trapped rats. All samples were examined by the method of trichinoscopy at authorized veterinary institutions of the County. Trichinosis infection was recorded in 1012 of 79,534 domestic pigs in the area exposed to pest control measures and in 51 of 53,494 domestic pigs from the rest of the County. RR for the exposure area vs. non-exposure area was 13.35 (95% CI 10.08-17.68; p<0.05); according to particular areas, RR was 3.66 (95% CI 2.62-5.13) for Pitomaca, 22.47 (95% CI 13.27-38.08) for Slatina and 118.89 (95% CI 29.7-476.01) for Orahovica (p<0.05 all). Domestic pigs from the County areas exposed to regular pest control measures had a 13-fold likelihood of infection recorded in pigs from County areas where pest control measures were not or were only occasionally performed. Quite unexpectedly, these results revealed a failure of pest control to reduce the incidence of trichinosis. The spread of trichinosis obviously occurs by some routes obviating the impact of pest control.

[Systematic preventive rodents control: correlation between mode of finance and level of coverage]. / Sistematska preventivna deratizacija: povezanost modela financiranja i visine obuhvata.

The aim of this article was to define correlation between the mode of financing systematic prventive rodents control and the level of coverage, by method of professional supervision in the area of Virovitica-Podravina county. Obtained results show significant diversity in the level of coverage between local self management units. In some cases, only 18% of households were covered by treatment, while in some other, where coverage was maximal, it reached 100%. We can conclude that community leaders of some local self management units do not recognize the importance of systematic preventive rodents control as a major public health measure. A portion of treatments executed under professional supervision results with low coverage because of mode of finance. Systematic preventive rodents control must be financed completely from budget resources of local self management units, which results in satisfying coverage and efficacious prevetive measure.

[Preventive measures for improvement of suitability of water from individual water supply objects in the areas ravaged by war]. / Preventivne mjere poboljsanja zdravstvene ispravnosti vode iz individualnih vodoopskrbnih objekata na podrucjima razorenim ratom.

The aim of this article was to test the success of sanation of unsatisfactory individual water supply objects in the areas ravages of war. 198 individual water supply objects were consolidated in the area of Vocin, with hyperchlorination and pumping out of water, after which desinfection with chlorine preparation was carried out. Samples of drinking water taken for bacteriological analysis were analyzed on total coliform bacteria, fecal coliform bacteria and fecal streptococci by method of membranous filtration, while the number of colonies of aerobic bacteria at 22 degrees C and 37 degrees C were determined on triptosis-glucosis-yeast agar. Good samples, considering the Regulations on health suitability of drinking water, were 152, or 77%. In unfit samples, which were 46, or 23%, the most common isolates were fecal streptococci, with frequency of 30%. Although public waterworks represent the best way to supply people with good drinking water, it is possible to achieve a satisfactory degree of water quality from individual water supply objects with implementation of public health activities, if we execute them periodically and professionally.

Serologically detected "new" tick-borne zoonoses in eastern Croatia.

AIM: To establish serologically a contact with causative agents of human monocytic and granulocytic ehrlichiosis, human babesiosis, recently detected rickettsioses, and Lyme disease in individuals with a history of tick bite from three counties in eastern Croatia. METHODS: Seroepidemiologic testing was performed in 102 subjects with a history of tick bite, who either requested examination for a tick bite or were suspected of having tick-borne disease. The study was carried out during the 1998-1999 period in the area of the Vukovar-Srijem, Osijek-Baranya, and Brod-Posavina counties. Serum analysis was performed by indirect immunofluorescence assay for the detection of antibodies to causative agents of human monocytic and granulocytic ehrlichiosis (Ehrlichia chaffeensis and human granulocytic ehrlichiosis agent), human babesiosis (Babesia divergens), and rickettsiosis. Enzyme-linked immunosorbent assay was used for the detection of antibodies to the spirochete Borrelia burgdorferi, the cause of Lyme disease. The assays were performed at the Department of Microbiology, Osijek Public Health Institute in Osijek, and their results were confirmed at the Department of Microbiology and Immunology, School of Medicine in Ljubljana, Slovenia. RESULTS: Ehrlichia chaffensis antibodies were detected in 5 sera, and antibodies to the causative agent of human granulocytic ehrlichiosis in 7 sera. A low titer of antibodies to the etiologic agent of babesiosis (Babesia microti) was detected only in a single serum. Eight sera that were positive for rickettsial antibodies contained rather high titers of antibodies against Rickettsia conorii, the agent of Mediterranean fever, and Rickettsia rickettsii, the agent of Rocky Mountain spotted fever. In six out of these 8 sera, antibodies to Rickettsia typhi, the cause of murine typhus, were detected possibly as a cross-reaction with some "newly detected" rickettsia circulating in this part of Europe, most likely Rickettsia slovaca. Positive titer of antibodies to Borrelia burgdorferi was detected in 15 sera. CONCLUSION: The agents of human monocytic and granulocytic ehrlichiosis and of possibly newly detected rickettsiae were indirectly demonstrated to circulate in eastern parts of Croatia. The results obtained by IFA failed to provide definite evidence for the circulation of the human babesiosis agent, because the IFA used in our study detected Babesia microti, which prevails in the USA, but not Babesia divergens, which is the predominant cause of the disease in Europe. Serologic evidence for Borrelia burgdorferi infection was demonstrated in 80% of the subjects suspected of having the skin manifestation of Lyme disease.